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Savita Halappanavar report: Tragic. Devastating.

Doctors need to know when they can intervene

More women could die in Irish hospitals in a manner similar to Savita Halappanavar unless legal clarity is provided for doctors on when they can intervene to terminate a pregnancy, the HSE report into her death has warned.

More women could die in Irish hospitals in a manner similar to Savita Halappanavar unless legal clarity is provided for doctors on when they can intervene to terminate a pregnancy, the HSE report into her death has warned.

The head of the inquiry team called on the Government yesterday to change the law to help doctors treating pregnant women who have rapidly escalating conditions such as sepsis, which caused Ms Halappanavar’s death.

“We need something in place where, if I’m a consultant, I know that no one can point the finger at me for carrying out a termination,” said UK-based obstetrician Prof Sir Sabaratnam Arulkumaran.

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Currently some consultants intervene earlier and others later on in pregnancy, but “much later on” might be too late to save a woman’s life.

The report suggests the Oireachtas should consider constitutional change to provide clarity in cases such as Ms Halappanavar’s.

However, Prof Arulkumaran said that having read the Government’s proposed legislation on abortion, he felt the issue would be dealt with by a legal change similar to that proposed in relation to the threat of suicide in pregnancy.

Counter the risk
Prof Arulkumaran said if Ms Halappanavar had been his patient in the UK, he would have performed a termination earlier in order to counter the risk of sepsis.

Treatment provided by University Hospital Galway, where Ms Halappanavar died last October after being admitted when 17 weeks pregnant, is heavily criticised by the inquiry team. Its report says there was inadequate assessment and monitoring to pick up the deterioration in her condition, a failure to adhere to hospital guidelines for managing sepsis and a failure to offer her all management options as she experienced inevitable miscarriage. A lack of recognition of the gravity of the risk to her health led to “delays in aggressive treatment”.

Minister for Health James Reilly expressed “serious concerns” about revelations in the report and said it “lays bare a set of unacceptable factors that led to the tragic death of a young woman”.

He has referred the report to the Medical Council and the Nursing and Midwifery Board of Ireland for consideration, and has invited the Institute of Obstetricians to meet him for talks on its implications.

The hospital and HSE apologised to Ms Halappanavar’s husband, Praveen, for the events in her care that contributed to her tragic death and sought to reassure the public they had made changes to ensure the circumstances of her death were not repeated. The report said the events had a devastating affect on her family.

Accept liability
Asked whether the HSE accepted liability for her death, a spokesman replied that no proceedings had been initiated so far. If that situation changed, the HSE would consider its position, along with the State Claims Agency.

Asked whether any disciplinary measures would be taken against staff, hospital clinical director Dr Pat Nash said it would await the outcome of a third report by the Health Information and Quality Authority before bringing recommendations to the board.

The report, which does not mention names, broadly makes the same findings as the inquest into Ms Halappanavar’s death did last April. Some new detail is provided about additional failings.

Mr Halappanavar is to seek a meeting with Dr Reilly, said his solicitor, Gerard O’Donnell.